Radioluminescence dosimetry solution for precision radiation therapy Project summary Radiation therapy (RT) is an important modality for cancer management. Clinically, over 60% of all cancer patients in the US receive RT each year as therapy or for palliation, or as an adjunct to surgery or chemotherapy. There is also increased evidence that RT in combination with checkpoint immunotherapy is highly effective in treating a subset of cancer patients. In practice, however, because of the invisible nature of X-ray and its complex interaction process with media, how to ensure the geometric and dosimetric accuracy of incident RT beams presents a significant challenge in precision RT and critically determines the success of patient treatment. In this project, we form an academic-industrial collaboration to investigate and create a clinically translatable solution for substantially improved RT quality assurance (QA) using a radioluminescence imaging technique recently developed at Stanford. On the basis of our promising preliminary work, we hypothesize that the accuracy, efficacy and cost of geometric and dosimetric QA measurements of linear accelerators (LINACs) can be substantially improved with the use of radioluminecsnce imaging strategy. With the proposed research, we anticipate that submillimeter accuracy in geometric measurements and better than 3% accuracy in dosimetric measurements will be readily achievable with orders of magnitude less time and effort as compared to current practice, removing a major workflow bottleneck in clinical QA and reducing potential radiation treatment errors. This research presents a first-of-its-kind machine QA strategy capable of instantaneously measuring complex geometric and dosimetric characteristics of LINACs. If successful, the partnership will lead to a much safer and more efficient radiation oncology practice, and enable patients to truly benefit from modern RT modalities such as VMAT and IMRT and SBRT. In addition, the proposed strategy is quite general and the system developed here will also be valuable for QA applications of other treatment modalities, such as proton therapy and high-dose rate (HDR) brachytherapy.